CLAIMS HANDLER- Health Insurance Client

CLAIMS HANDLER- Health Insurance Client (Health Insurance experience required) Key rolesThe role of the Claims Handler is to provide a quality service to the customers of leading Insurers, which meets or exceeds the Insurer’s expectations and generates the revenue to meet the demands of both Sedgwick’s and the Insurer’s businesses. Is it essential that the claims handler has previous experience working in the health insurance industry in Ireland. The Claims Handler will be expected to deliver and perform day-to-day tasks pertinent to the team’s activity with a major focus on Quality, Accuracy, S.L.A’s, Procedures and Process-improvement. The team member will also be expected to provide effective cover and assistance to the Team Leader.Specific responsibilities (including but not limited to)Takes full ownership of claim Process for our Clients – FNOL to Claim Payment Responsible for management of assigned desktop claims & delivery of targetProvide effective and accurate advice to claimants based on a strong working knowledge of policy terms and conditionsReview allocated cases and achieve settlement, within designated personal authority level, in line with established standards, procedures and guidance providedManage customer interactions in an efficient, courteous and timely manner in order to deliver high standards of customer satisfactionInteract with customers directly and liaise with Insurer representatives to ensure the highest level of service and continuous operational efficiencyReviewing Loss Adjusters Reports, Referrals / Correspondence on Managed AccountsAuthorisation of Payment with authority levelProvide assistance where required in the training of new Team MembersMaintain and update Personal Development PortfolioEnsuring that you achieve the minimum insurance standard qualification within the time frame and comply with CPD requirements where appropriateSuccessfully contribute to the development and delivery of the Team’s Goals, Objectives and ResultsQualifications/skillsPrevious Health Insurance experience essential Minimum competency requirements APA PL or CIP Qualification desirableHigh level of proficiency in Word, Excel, and PowerPointSound numeric skillsHigh level interpersonal and communication (verbal/written) skillsPersonal attributesSound knowledge of Sedgwick and its operation as a company (desirable but not essential)Willingness to operate flexible hoursCapacity to work independently and demonstrate initiativeInnovativeHave a full working knowledge of CPC & Central Bank of Ireland Regulatory RequirementsWillingness to work positively within a team environment with strong emphasis on support, flexibility and efficiencyUnderstand how to organise work and think through how to get things done most efficiently with the ability to perform on their own initiativeStrive to ensure Accuracy and Quality is delivered at all timesFocus on skills development. Take action to improve own and others’ job skillsMust have strong interpersonal and communication skills and be self-motivated, flexible and capable of working to critical deadlinesBenefits of working for Sedgwick in IrelandBike to Work SchemeTax Saver Travel SchemeDiscounted onsite Gym Membership (Dublin 4)Discounted onsite Montessori (Dublin 4)EAP – Employee Assistance Programme Health Insurance SchemeLife CoverPHI – Permanent Health InsuranceExams & Professional Membership FeesProfessional and personal development opportunitiesSedgwick Ireland is regulated by the Central Bank of Ireland (CBI). This role is subject to the Minimum Competency Code (MCC) as set out by the CBI. This code sets out the minimum professional standard for any person providing certain financial services, in particular when dealing with consumers. This role is classified as a Controlled function (CF5, CF6) and is subject to Fitness and Probity Standards, including the requirements outlined in the Individual Accountability Framework Act 2023. Successful candidates will receive training in relation to all regulatory requirements applicable to them.